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When Fibromyalgia Affects Your Feet

This chronic condition can cause pain right down to your toes. Here’s how to ease those aching tootsies.
Fibromyalgia treatment should extend from the top of your head to the tips of your toes — literally. Although feet are not the location most likely to experience fibromyalgia pain, in a recent paper published in the journal Arthritis Research and Therapy, about half of the 202 patients with fibromyalgia studied reported foot problems.

“Compensation for foot pain leads to pain in the knees, hips, and lower back,” says Dennis Frisch, DPM, a podiatrist in private practice in Boca Raton, Fla. If you’re already coping with fibromyalgia symptoms, this is added pain that you don’t need. Plus, foot pain increases the risk that you will fall and have an injury or simply be less active than you might want to be.

Chances are, with fibromyalgia you are aware of pain that other people just ignore. “In general, because people with fibromyalgia have higher sensitivity to pain and lower pain tolerance, they are more sensitive to pain everywhere,” says Dr. Frisch. In fact, experts believe that at least one in four people has foot pain, but many, if not most, simply don’t get treatment.

Reconnecting the Dots

There are also common sources of foot pain that aren’t directly connected to fibromyalgia but may be intensified by having this condition. One example is Morton’s neuroma, a benign enlargement of a nerve that causes tingling and shooting pain between the third and fourth toes. This unpleasant condition can be treated with cortisone shots or surgery.

Plantar fasciitis is also a common source of foot pain. With this condition, the soft connective tissue under the foot becomes inflamed and sore. It is often the result of bad choices in footwear. Choosing a supportive arch may help prevent the pain.

Being Active Despite Foot Pain

The problem with foot pain, says Frisch, is that it becomes a vicious cycle. Because people with fibromyalgia often feel fatigued, they may not get enough of the physical activity they need to feel better. Yet if they start trying to build up physical activity, they may initially feel some discomfort or even hurt their feet, blame it on fibromyalgia, and stop trying to be active. “Usually, for fibromyalgia, the recommendation is walking,” Frisch adds.

If you want to get moving with fibromyalgia and avoid unnecessary foot pain, try taking these steps:

Meet with your doctor. You should, of course, see your podiatrist if you feel any pain in your feet. But meeting with your podiatrist or doctor when you are trying to start an exercise regimen could help you make better decisions and keep your feet healthy.

Choose the right shoes. “Make sure you have the right shoe for whatever activity you are going to do,” advises Frisch. If you can afford it, it’s worth paying a little more for a quality shoe that will help prevent pain. Look for shoes that have a wide toe box, a supportive arch, and a sole that provides both support and flexibility.

Start gently. Fibromyalgia is a somewhat unpredictable condition, says Frisch. On a good day, you might be tempted to overdo exercise or wear too high a heel; opt for moderation if you want to avoid pain.

Expect and accept some discomfort. A little discomfort when you begin an exercise program is not unusual. But if you feel pain, it’s time to call your doctor.

Switch to lower heels for everyday wear. If you’re in love with heels, keeping the height down to about an inch is best for your fibromyalgia symptoms, says Frisch. If you really want to sport a higher heel, pack your sensible shoes in a large purse so you can make a quick and comfy change.

Finally, says Frisch, remember that your podiatrist can treat foot pain and make recommendations for better footwear and other changes but can’t address the big picture of fibromyalgia. A medical team approach is still best for complete fibromyalgia management.